﻿<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="utf-8">
    <title>{REPORT_TITLE}</title>
    <link rel="stylesheet" href="{STYLE}?v=1,32." type="text/css" media="screen" />
</head>
<body>
    <div class="container-fluid">
        <div class="row-fluid">
            <div class="span9">
                <div class="row-fluid">
                    <div class="span3">
                        &nbsp;&nbsp;
                    </div>
                    <div class="span9">
                        <h2 class="central" style="text-decoration: underline;">
                            Expense Claim Form
                        </h2>
                        <h4 class="central" style="color: Red;">
                            No.: {REQ_NO.}</h4>
                    </div>
                </div>
                <table class="goods-detail" align="center" cellspacing="0" cellpadding="0" border="1">
                    <thead>
                        <tr class="gridheader">
                            <th align="center">
                                Claim Date
                            </th>
                            <th align="center">
                                Currency of Expense
                            </th>
                            <th align="center">
                                Currency Converted to
                            </th>
                        </tr>
                    </thead>
                    <tbody>
                        <tr class="gridodd">
                            <td align="center">
                                {CLAIM-DATE}
                            </td>
                            <td align="center">
                                {EC-CURRENCY}
                            </td>
                            <td align="center">
                                {CURRENCY-CONVERTED2}
                            </td>
                        </tr>
                    </tbody>
                    <thead>
                        <tr class="gridheader">
                            <th align="center">
                                Expense Claim by
                            </th>
                            <th align="center">
                                Title
                            </th>
                            <th align="center">
                                Exchg. Rate of Conversion
                            </th>
                        </tr>
                    </thead>
                    <tbody>
                        <tr class="gridodd">
                            <td align="center">
                                {CLAIM-BY}
                            </td>
                            <td align="center">
                                {CAIM-TITLE}
                            </td>
                            <td align="center">
                                {EXG-RATE}
                            </td>
                        </tr>
                    </tbody>
                </table>
                <br />
            </div>
            <div class="span3">
                <table>
                    <tbody>
                        <tr>
                            <td>
                                <img src="{LOGO1}" alt="" />
                            </td>
                        </tr>
                        <tr>
                            <td>
                                <img src="{LOGO2}" alt="" />
                            </td>
                        </tr>
                        <tr>
                            <td>
                                DANISH REFUGEE COUNCIL<br />
                                Borgergade 10<br />
                                DK-1300 Copenhagen<br />
                                Denmark<br />
                            </td>
                        </tr>
                        <tr>
                            <td style="padding-top: 5px;">
                                COUNTRY OFFICE, UGANDA<br />
                                4688 Kalungi Road<br />
                                Muyenga, Kampala<br />
                            </td>
                        </tr>
                        <tr>
                            <td>
                                <a href="http://WWW.drc.dk">WWW.drc.dk</a><br />
                                <a href="http://WWW.danishdemininggroup.dk">www.danishdemininggroup.dk</a>
                            </td>
                        </tr>
                    </tbody>
                </table>
            </div>
        </div>
        <div class="row-fluid">
            <div class="span12">
                <table align="center" cellspacing="0" cellpadding="0" border="1" class="goods-detail">
                    <thead>
                        <tr class="gridheader">
                            <th rowspan="2">
                                Description
                            </th>
                            <th colspan="3">
                                Coding
                            </th>
                            <th colspan="2">
                                Transaction
                            </th>
                            <th colspan="2">
                                Currency Conversion
                            </th>
                        </tr>
                        <tr class="gridheader">
                            <th>
                                Account Code
                            </th>
                            <th>
                                Project No
                            </th>
                            <th>
                                Budget Line
                            </th>
                            <th>
                                Currency
                            </th>
                            <th>
                                Amount
                            </th>
                            <th>
                                Exchg. Rate
                            </th>
                            <th>
                                CNV* Amount
                            </th>
                        </tr>
                    </thead>
                    <tbody>
                        {DETAILS}
                    </tbody>
                    <tfoot>
                        <tr>
                            <th colspan="2" class="gridheader">
                                Master Budget Currency
                            </th>
                            <td align="center">
                                {MB-CURRENCY}
                            </td>
                            <th class="gridheader" colspan="2">
                                Total
                            </th>
                            <td align="right">
                                {MB-TOTAL}
                            </td>
                            <th colspan="2" class="gridheader">
                                Expence Claim Value
                            </th>
                        </tr>
                    </tfoot>
                </table>
            </div>
        </div>
        <br />
        <div class="row-fluid">
            <div class="span12">
                <table align="center" cellspacing="0" cellpadding="0" border="1" class="goods-detail">
                    <thead>
                        <tr class="gridheader">
                            <th width="19%">
                                Authorization
                            </th>
                            <th width="27%">
                                ECF Submitted by
                            </th>
                            <th width="27%">
                                Finance Review/Approval of BL/PN
                            </th>
                            <th width="27%">
                                EC Authorized by Manager/CD
                            </th>
                        </tr>
                    </thead>
                    <tbody>
                        {AUTHORISATION}
                    </tbody>
                </table>
            </div>
        </div>
        <br />
        <div class="row-fluid">
            <div class="span12">
                <table align="center" cellspacing="0" cellpadding="0" border="1" class="goods-detail"
                    id="Table2">
                    <thead>
                        <tr class="gridheader">
                            <th>
                                Expense Claim
                            </th>
                            <th>
                                Settlement paid by
                            </th>
                            <th>
                                Settlement Received by
                            </th>
                            <th>
                                Settlement
                            </th>
                            <th>
                                Currency
                            </th>
                            <th>
                                Amount
                            </th>
                            <th>
                                Exchg. Rate
                            </th>
                            <th>
                                Converted Amount
                            </th>
                        </tr>
                    </thead>
                    <tbody>
                        {EC-DETAILS}</tbody>
                </table>
            </div>
        </div>
    </div>
</body>
</html>
